CA Welf & Inst Code Section 14006.7


(a)

At the time of application for Medi-Cal benefits, the department shall provide to any applicant who is aged, blind, or disabled, other than an individual applying for, or receiving, aid under Chapter 2 (commencing with Section 11200), Article 5 (commencing with Section 12200) of Chapter 3, or Article 7 (commencing with Section 12300) of Chapter 3, and to the applicant’s spouse, legal representative, or agent, if any, a clear and simple statement, in writing, in a form and language specified by the department, that explains the circumstances under which an interest in a home may be transferred for less than fair market value without affecting Medi-Cal eligibility.

(b)

The statement required by subdivision (a) shall be in the following form:
A transfer of property interest for less than fair market value in a Medi-Cal beneficiary’s home will not cause ineligibility for Medi-Cal benefits if at the time of the transfer, the home would have been considered an exempt resource.
This is only a brief description of the Medi-Cal eligibility rules. For more detailed information, you should call your county welfare department. You will probably want to consult with an attorney, your local legal services program for seniors, or the local branch of the long-term care ombudsman program.
I have read the above notice and have received a copy.
Dated: ______ Signature: _________”

(c)

The statement required by subdivision (a) shall be printed in at least 12-point type, shall be clearly separate from any other document or writing, and may be signed by the applicant, the applicant’s spouse, legal representative, or agent, if any. Failure to sign this form shall not result in ineligibility for medical assistance.

(d)

The department may revise this statement as necessary to maintain its consistency with state and federal law.

(e)

In the case of an applicant applying for Medi-Cal reimbursement for nursing facility care, the statements required under Sections 14006.2 and 14006.3 shall apply, and the statement required by subdivision (a) shall not be provided.
14000
14000.1
14000.2
14000.03
14000.3
14000.4
14000.05
14000.5
14000.7
14001
14001.1
14001.11
14002
14002.5
14003
14004
14005
14005.1
14005.2
14005.3
14005.4
14005.5
14005.6
14005.7
14005.8
14005.9
14005.10
14005.11
14005.12
14005.13
14005.14
14005.15
14005.16
14005.17
14005.18
14005.19
14005.20
14005.21
14005.22
14005.23
14005.24
14005.25
14005.26
14005.27
14005.28
14005.29
14005.30
14005.31
14005.32
14005.33
14005.34
14005.35
14005.36
14005.37
14005.39
14005.40
14005.41
14005.42
14005.50
14005.60
14005.61
14005.63
14005.64
14005.65
14005.66
14005.67
14005.68
14005.70
14005.73
14005.75
14005.76
14005.84
14005.85
14005.88
14005.89
14005.225
14005.271
14005.275
14005.277
14005.285
14005.287
14005.288
14006
14006.1
14006.01
14006.2
14006.3
14006.4
14006.5
14006.6
14006.7
14006.15
14006.41
14007
14007.1
14007.2
14007.4
14007.5
14007.6
14007.7
14007.8
14007.9
14007.15
14007.45
14007.65
14007.71
14007.95
14007.705
14008
14008.6
14008.7
14009
14009.5
14009.6
14009.7
14010
14011
14011.1
14011.2
14011.3
14011.4
14011.5
14011.6
14011.7
14011.8
14011.9
14011.10
14011.15
14011.25
14011.65
14011.65a
14011.65b
14011.66
14011.75
14011.78
14012.5
14013
14013.3
14013.5
14014
14014.5
14015
14015.1
14015.2
14015.5
14015.7
14015.8
14015.12
14016
14016.1
14016.2
14016.3
14016.4
14016.5
14016.6
14016.7
14016.8
14016.9
14016.10
14016.51
14016.55
14017
14017.1
14017.5
14017.6
14017.7
14017.8
14018
14018.1
14018.2
14018.4
14018.5
14018.7
14019
14019.3
14019.4
14019.5
14019.6
14019.7
14020
14021
14021.2
14021.3
14021.4
14021.5
14021.6
14021.7
14021.8
14021.9
14021.30
14021.31
14021.33
14021.35
14021.51
14021.52
14021.53
14022
14022.1
14022.3
14022.4
14022.5
14023
14023.7
14024
14025
14026
14026.5
14027
14029
14029.5
14029.8
14029.91
14040
14040.1
14040.5
14041
14041.1
14041.5
14042
Last Updated

Aug. 19, 2023

§ 14006.7’s source at ca​.gov